REIMBURSEMENT SPECIALIST

Salary : $56,056.00 - $72,051.20 Annually
Location : City Hall, 730 Washington Avenue, Racine, WI
Job Type: Full-Time
Job Number: 202600058
Department: Health Department
Opening Date: 07/06/2026
Closing Date: Continuous


Job Description

CONTINUOUS POSTING UNTIL POSITION FILLED

We strongly encourage City of Racine residents to apply. We're committed to building a workforce that reflects and understands the community we serve. City residents will earn a 4% differential on top of the hourly pay range. Learn more and apply today!

POSITION PURPOSE:
Promotes and supports the Public Health Department by providing a variety of financial, clerical, administrative, and technical support services. Responsibilities include, but are not limited to, healthcare claims processing, financial reporting, as well as other special projects as assigned. Ensures the integrity of accounting information by recording, verifying, consolidating, and entering transactions. The Reimbursement Specialist reports to the Deputy Public Health Administrator and/or their designee.

Essential Duties

• Process and reconcile patient billing, claims, reimbursements, and revenue transactions while ensuring accuracy, compliance, and timely submission of claims.
• Review, correct, and follow up on denied, rejected, disputed, or delayed claims; maintain reimbursement records and update client accounts accordingly.
• Ensure compliance with HIPAA, Medicaid, legal, regulatory, and coding requirements; communicate coding updates and reimbursement changes to staff.
• Manage provider portals, revalidations, medical records, account databases, and reporting systems to maintain accurate records and generate required reports.
• Assist clients with intake, eligibility screening, licensing applications, referrals, and access to community and social service programs.
• Prepare correspondence, contracts, reports, grant documentation, and other administrative records while maintaining confidentiality and data integrity.
• Manage cash handling activities, including processing payments, reconciling transactions, preparing deposits, and maintaining financial records using MUNIS.
• Monitor grants and contracts to ensure compliance with objectives, deliverables, reporting requirements, and funding guidelines.
• Provide customer service by addressing inquiries, resolving concerns, processing requests, and explaining departmental procedures and regulations.
• Support departmental operations through cross-training, staff training, quality assurance activities, emergency response collaboration, meeting participation, and maintaining reliable attendance.

Qualifications

Knowledge, Skills, and Abilities Required

• Working knowledge of community systems, ability to initiate referrals to community health care providers, social service, and advocacy agencies, and the ability to effectively refer clients as needed.
• Knowledge of HIPAA compliance standards and all aspects of client privacy practices.
• Knowledge/experience evaluating health trends and risk factors of target populations.
• Ability to establish professional relationships with clients, peers, supervisors and community organization members.
• Personal initiative combined with the ability to work independently and interdependently.
• Substantial working knowledge of and experience with current Microsoft Office suite or newer (Word, Excel, Outlook, PowerPoint, and Publisher), desktop publishing, and the internet, combined with the ability to pass all required skills tests.
• Previous experience working with large/specialized databases and preparing data for analysis.
• Ability to analyze data and/or manipulate data in Microsoft Excel and/or applicable databases using established criteria to determine significance and assess outcomes.
• Must be able to compare, count, measure, copy, compute, tabulate, and categorize data combined with the ability to pass all required skills tests.
• Ability to effectively acquire and utilize scientific/client data obtained from a variety of sources including patient records, lab reports, physician orders, maps, flow charts, and statistical reports.
• Ability to comprehend, utilize, and implement information from a variety of sources including personnel policies, employee performance evaluations, time study sheets, policy documents, nursing procedure manuals, scientific medical textbooks, and computer software operating manuals.
• Proficient oral/written English language skills, including proper spelling, punctuation and grammar with the ability to pass required skill tests.
• Effective oral and written communication skills at all levels of responsibility including clients and their families, physicians, local, state, and federal personnel, pharmacists, hospital and jail personnel.
• Ability to assist in the development, submission, and implementation of successful grant proposals.
• Ability to interpret, regulate, and enforce state/local/federal laws, regulations, and rules.

Minimum Qualifications

• Associate's degree in accounting or related field and three years of experience in medical billing, coding, healthcare administration, or related office and system support, preferably in a healthcare setting, or any equivalent combination of education, training, and experience.
• A valid Wisconsin driver's license and reliable motor vehicle with mandatory levels of insurance coverage.
• Current CPR/AED/First Aid Certification or the ability to obtain such certification within six months of hire. Certifications must be maintained for the duration of employment.

Preferred Qualifications

• Qualified applicants will possess Certified Professional Coder (CPC), Certified Coding Associate (CCA), or the Registered Health Information Technician (RHIT) required/preferred.
• Three (3) years work experience with a governmental public health agency.
• Knowledge of third party and Medicaid Billing rules and Medical Coding certification.
• Bilingual proficiency (Spanish/English).
• Customer Service experience is strongly preferred.
• Experience working with various racial and ethnic groups.
• Advanced proficiency using Microsoft Office applications (word, excel, etc.) preferred.
• Experience in public speaking with the ability to present data and other program materials in Microsoft PowerPoint.

Supplemental Information

Physical Demands of the Position

• Standing, walking, sitting, and stooping.
• Kneeling, crouching, climbing, balancing and bending/twisting.
• Reaching, lifting, carrying, pushing/pulling (up to 35 lbs.).
• Handling, grasping, fingering, filing, typing, and writing

The City of Racine is an Equal Opportunity Employer. In compliance with the Americans with Disabilities Act, the City will provide reasonable accommodations to qualified individuals with disabilities and encourages both prospective and current employees to discuss potential accommodations with the employer.
City Employee Benefits - 2026

• Health Insurance
  1. 92.5% of the Premium is paid by the City of Racine - either single or family.
     • Centivo administers the PPO Plans that are offered. You can chose from two high-deductible health plans and one low-deductible health plan, with two different networks offered.
     • CVS Caremark administers our prescription plan
  2. Payment of $50 per month to employees who waive health coverage
• Health Savings Account (H.S.A.)
  1. A Health Savings Account (H.S.A.) is a tax beneficial savings account that can be used in conjunction with a qualified High - Deductible Health Plan. The funds put into an H.S.A. may be used on future, eligible health care expenses without any taxation. The City makes a prorated, one-time contribution to an employee's Health Savings Account, with the amount of the contribution determined at the time of hire.
  2. The maximum contribution amounts are determined by the IRS each year.
• Racine Employee Health & Wellness Center
  1. The Employee Health and Wellness Center run by Ascension Wisconsin is available to you and your dependent(s) if enrolled in the medical insurance
  2. It provides comprehensive services including clinic visits, health coaching, and preventative exams and health screenings.
• Life Insurance
  1. City provides one unit equal to your annual earnings
  2. Employee may buy additional insurance - each unit is equal to your annual earnings.
  3. Maximum additional life insurance is four units; For a total of five (5) units at the maximum coverage.
  4. Cost depends on age and annual salary
  5. Spouse and Dependent Life Insurance is available - maximum coverage is $20,000 for spouse and $10,000 for dependents, cost is $3.20 per month or half for $1.60/month
• Pension
  1. Wisconsin Retirement System, the contribution rate for 2026 is 14.4% Funded 50% by the City of Racine and 50% by the employee.
  2. Rates can change per year depending upon what is approved through WRS.
• Vacation
  1. Less than 4 years of continuous service - 96 hours
  2. At least 4 years but less than 9 years of continuous service - 136
  3. At least 9 years but less than 14 years of continuous service - 176
  4. At least 14 years but less than 21 years of continuous service - 216
  5. At least 21 years of continuous service - 256
  6. You may carry over up to 80 hours into the next year.
  7. During the first calendar year of employment, new employees shall earn vacation on a prorated basis based on the new employee's start date.
• Holidays
  1. 13 paid holidays, 12 scheduled and 1 floating
• Sick Leave
  1. Accrues at the rate of 1 day per full month worked.
• Casual Days
  1. You can earn up to 4 casual days based off the amount of sick time that you have accrued.
  2. You are also eligible for an additional casual day if you use 16 hours or less of sick time in the preceding year.
• Dental Insurance
  1. MetLife administers our dental plan with two options available to employees (Basic plan or Advanced plan). Employees pay the premium with a pre-tax payroll deduction.
  2. The City of Racine pays for the Basic Employee premium if you are enrolled in the medical insurance.
• Vision Insurance
  1. Superior Vision administers our vision plan with one option. Employees pay the premium with a pre-tax payroll deduction.
• Flexible Spending Plans
  1. Medical and Dependent Care Flexible Spending Accounts administered by Health Equity.
  2. The maximum contributions are determined by the IRS each year.
• Short Term Disability Policy
  1. Automatically enrolled in a short-term disability insurance policy through MetLife, excludes Water and Wastewater Utility Employees.
  2. 70% of annual income, up to 13 weeks with a maximum benefit of $2,000 weekly.
• Employee Assistance Program
  1. The City of Racine offers an employee assistance program through Advocate Aurora.
• Parental Leave
  1. 320 hours of paid parental leave, if eligible for FMLA. Water and Wastewater Utility employees are eligible for 80 hours.
• Deferred Compensation
  1. Provided through Nationwide, Security Benefit (RPA/The Standard) or Wisconsin Deferred Comp.
• Supplemental Insurance
  1. Provided through AFLAC Funded by payroll deduction
  2. Accident, Hospital & Cancer policies are available
• Tuition Reimbursement
  1. $4,000 per year, or 80% of the employee's total tuition cost, whichever is lower.
• Student Loan Repayment Program
  1. The Student Loan Repayment Program, administered by Bakertilly Vantagen, helps assist you with the financial burden of the education that you have received. Non City of Racine residents can receive up to $1,200 per year towards student loan repayments, and City of Racine residents can receive up to $2,400 per year towards student loan repayments.
• Public Service Loan Forgiveness (PSLF)
  1. The PSLF Program promotes full-time public sector employment. Public Employees, may qualify for public service loan forgiveness after making 120 payments toward their student loans while working full-time in public service. This means that nurses, policeman, firefighters, public health, and government employees can be eligible for participation. The Forgiveness Program was designed uniquely to provide relief to those who are doing the best for our communities every day. To find out if you qualify for a forgiveness program call View phone number on click.appcast.io.
• Wellness Incentive
  1. Employees, spouses, and retirees covered by the City health insurance plan who complete the Wellness Incentive requirements are eligible to receive $200, spouses receive $100.
• Fitness Reimbursement
  1. Employees, spouses, and retirees covered by the City health insurance plan are eligible for 50% reimbursement of their annual membership fee up to a maximum of $200 per household.
  2. Reimbursement also includes fitness classes and weight reduction programs.
• City of Racine Residency
  1. City of Racine employees that are non-represented are eligible for a 4% per hour pay differential if you provide proof that you are City of Racine resident.
     • City of Racine residency pay differential rates are different for:
       • Racine Police Association - 3% differential rate
       • Local 321 Firefighter Union - 3% differential rate
       • Transit Union - 2% differential rate
  2. You can receive additional City contribution into your H.S.A. account if you are a City of Racine Resident. Residency contributions are based on what
• Homebuyer Down payment Assistance Program
  1. The City of Racine Employee Homebuyer Assistance Program offers up to $10,000 in down payment and closing cost assistance to help you purchase your dream home in the City of Racine - Submission deadline for applications is August 1st, 2026.
• Racine Financial Empowerment Center
  1. The Racine Financial Empowerment Center (FEC) provides free one-on-one professional financial counseling for all City of Racine employees, and residents of the City of Racine.

Additional information about the City's comprehensive benefits package can be found on the following website;
01


Do you posses an Associate's degree in accounting or related field?

• Yes
• No

02


What is your highest level of education?

• High School Diploma or Equivalent
• High School Diploma or Equivalent with Some College
• Associate's Degree
• Bachelor's Degree
• Master's Degree
• Doctorate (PHD)
• None

03


How many years of accounting experience in healthcare do you have?

• one year
• two years
• three years
• four or more years
• none of the above

04


Are you bilingual (English\Spanish)?

• Yes
• No

05


How many years' experience do you have working with a governmental public health agency?

• None
• 1 to 3 years
• 4 to 7 years
• 8 or more years

06


How many years of experience do you have with Microsoft Office (Microsoft Word, Microsoft Excel, etc.)?

• Less than 1 year
• 1-2 years
• 3-4 years
• 5 or more years
• None of the Above

07


Do you possess current CPR/AED/First Aid Certification?

• Yes
• No

08


This position requires one of the following certifications, select from choices:

• Certified Professional Coder (CPC)
• Certified Coding Associate (CCA)
• Registered Health Information Technician (RHIT)
• None

09


Please describe your experience with healthcare billing or reimbursement.
Required Question